MAEA
O
nline Proposal Form-06
*
P
resenter Information
N
ame:
H
ome Address
*
H
ome Phone
W
ork Address
W
ork
Phone
E
mail
M
embership No.
Please indicate the section and program category that is appropriate for your presentation.
P
rogram
Category
Section Category
Curriculum Concept/Program
Elementary K-3
H
igher Education
Media Demonstration
E
lementary 4-6
M
useum Education
Theory and/or Research
Middle School/Jr.High
S
upervision/Admn.
Hands-on Workshop
High School
R
etired Affiliate
Other (describe /explain)
Would you be willing to present this program/workshop more than once?
N
o
Y
es
T
itle
of Presentation
L
ist Show-Me Standards addressed (ex, FA1, Goal 2.5, etc.)
D
escription of Presentation
( Be brief, but as descriptive as possible)
TYPE:
TIME:
AV EQUIPMENT (Spring Conference Only):
P
resentation
3
5mm Slide Projector
T
V/VCR
Panel Discussion
3
0 Min.
1
Screen
6
0 Min
W
orkshop
2
Screens
9
0 Min.
O
verhead Projector
O
ther
T
wo Sessions
P
resenter supplies Equipment not listed
.
Date
If you prefer to mail, Please print and send to:
Rebecca Moppin
917 East Auburn St.
Bolivar, MO 65613
Title of Presentation
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